This application is in response to RFA CA-92-02: National Collaborative Diagnostic Imaging Trial Projects. Imaging Technology has improved rapidly in the last decade, associated with these improvements are significant increases in the cost of these procedures. An accurate assessment of these technologies is required to develop the most efficacious imaging strategy for patients with ovarian cancer. The long-term objective of this proposal is to evaluate the relative roles of these imaging modalities in the diagnosis and staging of ovarian cancer. Specifically, the relative accuracies of (multi-coil array, fast spin echo) MRI and spiral CT in the detection of metastatic peritoneal implants will be determined. The accuracies of transvaginal color doppler sonography, spiral CT and (multi-coil array, fast spin echo) MRI with intravenous gadolinium enhancement will all be evaluated for their ability to differentiate benign from malignant ovarian masses. The relative accuracies of spiral CT and multi-coil array MRI in the detection of recurrent or residual disease in patients undergoing therapy will also be evaluated. The receiver operating characteristic curves and feature analysis statistical methods will be used to compare the performance of each modality. These will be used, also, to determine the appropriate diagnostic criteria for each modality. Detailed pathological correlations are proposed as the measure of truth for both the differentiation of benign and malignant ovarian masses and the detection of metastatic peritoneal implants. The data acquired through this prospective multi-collaborative study will form the basis for developing optimized decision trees in imaging of ovarian cancer.